THE HARBORS ASSISTED & INDEPENDENT LIVING EMPLOYMENT APPLICATION
The Harbors Assisted & Independent Living is an equal opportunity employer. This application will not be used for limiting or excluding any applicant from consideration for employment on a basis prohibited by local, state, or federal law. Applicants requiring reasonable accommodation in the application and/or interview process should notify a representative of the organization.
First Name *
Last Name *
Email Address *
Phone Number *
Mailing Address *
Are you over the age of 18? *
What is your availability? *
Required
If hired, when would you be able to start working? *
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Can you work weekends? *
Can you work nights? *
Required
Are you willing to perform a background check? *
Have you ever worked for The Harbors Assisted & Independent Living? *
Do you have any friends, relatives or acquaintances working for The Harbors Assisted & Independent Living? *
Do you have reliable transportation? *
Are you able to perform the functions of the job for which you are applying for, either with or without reasonable accommodation? *
If you answered "No" to the above then please describe the functions that you would not be able to perform:
Are you willing to pick up shifts and cover for others shifts? *
Have you ever been convicted of a crime? *
If you answer "Yes" please explain:
Are you willing to work Holidays? *
If hired, are you willing to submit to a drug test and TB test before you start your employment? *
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